Numerous procedures have been developed that require the percutaneous insertion of one or more medical devices into the body of a patient. Such procedures include, for example, percutaneous transluminal coronary angioplasty (PTCA), X-ray angiographic procedures, embolization procedures, and the like. The medical devices intended for use in such procedures may be introduced into the vascular system by a variety of known techniques. For example, in the widely used Seldinger technique, a surgical opening is made in a body vessel, such as an artery or vein, by a needle, and a guidewire is inserted into the body vessel through a bore in the needle. The needle is then withdrawn, leaving the guidewire in place. A dilator positioned within the lumen of an introducer device is then inserted over the guidewire and advanced into the body vessel. Once the introducer is positioned as desired within the body vessel, the dilator is withdrawn. A variety of medical devices, such as catheters, delivery systems, cardiac leads, and the like, can then be advanced through the introducer to a point of treatment in the body vessel. For example, a delivery system that includes a guidewire with an attached embolization coil can be introduced through the introducer to a point of treatment and delivered using conventional techniques (e.g., rotating the guidewire such that the embolization coil becomes free of the guidewire).
In many cases, an introducer will include one or more hemostatic valve members (also referred to as check valves) for inhibiting leakage of bodily fluids, such as blood, through the introducer as a medical device is inserted through or withdrawn from the introducer. In some cases, hemostatic valves that include a valve member, such as an elastomeric member, are used to minimize fluid leakage during these exchanges. Hemostatic valves of this type are dependent upon the ability of the valve member to seal around the interventional devices to close any gaps created upon insertion or withdrawal of the device through the valve.
The introduction and maneuvering of medical devices, such as guidewires, through a valve member of a hemostatic valve present various challenges. For example, when disposed through a valve member, a guidewire can be difficult to introduce and withdraw from the valve member and rotation of the guidewire relative to the valve member can require two hands, which increases the complexity of the procedure. In addition, the manipulation of the guidewire through the valve member sometimes results in the guidewire becoming kinked, which may result in the guidewire becoming unsuitable for continued use throughout the remainder of the procedure. Control handles for guidewires have been developed that can be used during the performance of a procedure. However, these devices fail to provide support for the guidewire through valve members and also fail to provide a mechanism for rotating the guidewire relative to a portion of the control handle when the guidewire is disposed through a valve member. Thus, there is a need for improved rotatable control handles and methods of using rotatable control handles.